Monday, April 13, 2009

FDA Suggests that Electronic Cigarettes are No Safer than Conventional Ones

Health Advocates Want Testing of E-Cigs for Safety, But Have No Problem Approving the Proven Hazardous Ones

The Food and Drug Administration (FDA) has publicly suggested that electronic cigarettes are no safer than conventional ones.

In an interview on NPR's Morning Edition, FDA spokeswoman Rita Chappelle stated: "We're concerned about the potential for addiction to and abuse of these products. Some people may mistakenly perceive these products to be safer alternatives to conventional tobacco use."

Anti-smoking groups continue to call for an immediate ban on electronic cigarettes, arguing that these products should not be on the market until they are studied and proven safe through clinical trials.

Interviewed by NPR, the American Cancer Society's Dr. Thomas Glynn stated: "I think there's a lot of possibilities; it's intriguing. But it needs to go through some rigorous testing before the public health community would feel comfortable with it. Any product that we ingest, we'd like to see go through the Food and Drug Administration. I mean, we know more, to be honest, about what's in dog food and macaroni and cheese than we know what's in tobacco in this country. And there's no reason to introduce yet another product where we don't know what we're ingesting."

The Rest of the Story

Ironically, the American Cancer Society is supporting legislation by which the FDA will officially approve the existing conventional cigarettes which have already been studied extensively and been shown to be toxic and deadly, killing more than 400,000 people each year.

What is the point of knowing about the ingredients in cigarettes if you are simply going to approve the product? How does it protect the public to know what's in the cigarette and if those ingredients are safe if you are not going to require that unsafe ingredients are removed from the cigarette? The FDA legislation does nothing to actually make cigarettes safer. In contrast, the electronic cigarette does, and it appears to be not only popular, but highly demanded among smokers who want to quit smoking.

The point is that the health groups' position is absurd. They are saying that we can't allow a demonstrably safer alternative product on the market (which contains essentially no tar, just nicotine) until it is vigorously tested and proven safe, yet we can not only allow but officially approve hundreds of products that we already know are extremely unsafe.

The result of this absurdity is going to be the loss of lives, as the removal of e-cigs from the market will almost surely result in many e-cig users reverting back to cigarette smoking.

The other interesting aspect of this story is that the FDA is stating that electronic cigarettes are no safer than conventional ones. This is an irresponsible, inaccurate, and potentially damaging statement.

Electronic cigarettes are obviously safer than conventional cigarettes because while they contain nicotine, they do not contain the hundreds of other chemicals and they do not contain the carcinogens. It's not going to take extensive clinical trials to make that determination. How can nicotine not be less hazardous than nicotine plus all the hundreds of other chemicals in tobacco smoke?

Moreover, for the FDA to approve electronic cigarettes, they would have to be shown to be safe. This is unlikely, because we know that nicotine does have some hazardous effects. It has been implicated as playing a role in the development of heart disease, for example. So if the FDA assumes jurisdiction over electronic cigarettes as a drug delivery device, the reality is that we will not see these products approved. They would have to be re-marketed solely as a form of nicotine replacement therapy, and that is not the way the products are currently being marketed. They are currently being marketed as a safer alternative to cigarette smoking.

So the simple choice is: either the health groups need to rescind their call for the FDA to assume jurisdiction over e-cigarettes or else they are ensuring that a potentially life-saving intervention will not be available.

The rest of the story is that the FDA is spreading information that is demonstrably false. I find this to be irresponsible and possibly destructive as well.

Why lie to people just because we don't like the idea of people using something that looks like a cigarette? It serves no public health purpose. In fact, it runs counter to protecting the public's health.

Sadly, it doesn't seem that health is the primary objective of many groups in tobacco control any more. Instead, the primary concern appears to be more of an ideological one.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.